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Sugitani Y, Muneuchi J, Watanabe M. Home-inhaled nitric oxide in a child with pulmonary arterial hypertension associated with post-operative pulmonary venous obstruction. Cardiol Young 2023; 33:2673-2675. [PMID: 37846473 DOI: 10.1017/s1047951123003591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Home-inhaled nitric oxide therapy was effective and feasible in the patients with intractable pulmonary arterial hypertension. We present the case of a child with severe pulmonary arterial hypertension associated with post-operative pulmonary venous obstruction who was treated with home-inhaled nitric oxide therapy.
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Affiliation(s)
- Yuichiro Sugitani
- Department of Pediatrics, Kyushu Hospital, Japan Community Healthcare Organization, Kitakyushu, Japan
| | - Jun Muneuchi
- Department of Pediatrics, Kyushu Hospital, Japan Community Healthcare Organization, Kitakyushu, Japan
| | - Mamie Watanabe
- Department of Pediatrics, Kyushu Hospital, Japan Community Healthcare Organization, Kitakyushu, Japan
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Zeng X, Liu Q, Rathinasabapathy A, Zha L, Liu D, Tang Y, Sun J, Luo H, Yu Z. Pulmonary veno-occlusive disease in Sjogren's syndrome: a case report. BMC Pulm Med 2023; 23:26. [PMID: 36653758 PMCID: PMC9847112 DOI: 10.1186/s12890-023-02322-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) associated with connective tissue disease (CTD) belongs to Group 1 pulmonary hypertension. Pulmonary veno-occlusive disease (PVOD), which is characterized by venous system aberrations, has been previously reported in CTD-PAH; however, it has rarely been observed in Sjogren's syndrome (SS). CASE PRESENTATION Our 28-year-old female patient was admitted to the hospital with recurrent shortness of breath even after minimal physical activity. Her chest high-resolution CT scan demonstrated pulmonary artery dilatation and bilateral ground-glass nodules. A subsequent right heart catheterization confirmed pulmonary hypertension because her mean pulmonary arterial pressure was 62 mmHg. Our inquisitive genomic assessment identified a novel EIF2AK4 mutation at c.1021 C > T (p. Gln341*), the dominant causal gene of PVOD. Histological examination demonstrated stenosis and occlusions in the pulmonary veins. Because she presented with features such as dry eyes and Raynaud's phenomenon, we performed a biopsy on the labial salivary gland, which confirmed SS. Her treatment regimen included PAH-targeted therapies (tadalafil and macitentan) in combination with hydroxychloroquine. Although she was hospitalized several times due to acute exacerbation of PAH, her disease progression was under control, and she did not demonstrate any signs of pulmonary edema even after a three-year treatment period. CONCLUSION Here, we report the case of an SS-PAH patient with PVOD who carried a novel biallelic EIF2AK4 mutation, and PAH-targeted therapies were well tolerated by our patient.
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Affiliation(s)
- Xiaofang Zeng
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Qiong Liu
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China
| | - Anandharajan Rathinasabapathy
- grid.412807.80000 0004 1936 9916Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN USA
| | - Lihuang Zha
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China
| | - Dongliang Liu
- grid.452223.00000 0004 1757 7615Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Yiyang Tang
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Jing Sun
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Hui Luo
- grid.508008.50000 0004 4910 8370Department of Cardiology, The First Hospital of Changsha, Changsha, Hunan China
| | - Zaixin Yu
- grid.452223.00000 0004 1757 7615Department of Cardiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
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Zhang C, Du Q, Wang S, Zhang R. A rare compound heterozygous EIF2AK4 mutation in pulmonary veno-occlusive disease. BMC Pulm Med 2022; 22:455. [PMID: 36451176 PMCID: PMC9710057 DOI: 10.1186/s12890-022-02256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pulmonary veno-occlusive disease (PVOD) is a rare, progressive, and oft-fatal condition of pulmonary arterial hypertension that is typically difficult to diagnose and treat. However, with the development of next-generation sequencing technology, an increasing number of patients with PVOD are being diagnosed. METHODS Initially, we used whole exome sequencing (WES) to identify the proband as a rare compound heterozygous mutation of EIF2AK4 in PVOD. Subsequently, the parents of patient underwent EIF2AK4 screening by Sanger sequencing. RESULTS In this study, we describe the family tree of a patient with PVOD with a rare compound heterozygous EIF2AK4 mutation. Moreover, we identified a new EIF2AK4 mutation, c.2236_2237insAAGTCCTTCT, in exon 12 of the proband and his mother. This frameshift mutation led to premature termination of the coding protein sequence and widespread loss of protein function, which promoted the development of PVOD. CONCLUSIONS Our results expand our understanding of the EIF2AK4 mutation spectrum in patients with PVOD, as well as highlight the clinical applicability of WES.
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Affiliation(s)
- Chun Zhang
- grid.452290.80000 0004 1760 6316Department of Respiratory Medicine, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Nanjing City, Jiangsu Province People’s Republic of China
| | - Qiang Du
- grid.452290.80000 0004 1760 6316Department of Respiratory Medicine, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Nanjing City, Jiangsu Province People’s Republic of China
| | - Sha Wang
- grid.511046.7DIAN Diagnostics, Hangzhou, People’s Republic of China
| | - Ruifeng Zhang
- grid.452290.80000 0004 1760 6316Department of Respiratory Medicine, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Nanjing City, Jiangsu Province People’s Republic of China
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